Survey Study of Anesthesiologists' and Surgeons' Ordering of Unnecessary Preoperative Laboratory Tests

@article{Katz2011SurveySO,
  title={Survey Study of Anesthesiologists' and Surgeons' Ordering of Unnecessary Preoperative Laboratory Tests},
  author={R. Katz and F. Dexter and K. Rosenfeld and Laura Wolfe and Valerie Redmond and Deepti Agarwal and Irim Salik and K. Goldsteen and Melody Goodman and P. Glass},
  journal={Anesthesia \& Analgesia},
  year={2011},
  volume={112},
  pages={207–212}
}
BACKGROUND:Nearly 20 years ago it was shown that patients are exposed to unnecessary preoperative testing that is both costly and has associated morbidity. To determine whether such unnecessary testing persists, we performed internal and external surveys to quantify the incidence of unnecessary preoperative testing and to identify strategies for reduction. METHODS:The medical records of 1000 consecutive patients scheduled for surgery at our institution were examined for testing outside of our… Expand

Paper Mentions

Observational Clinical Trial
In this prospective and paired study, the investigators evaluate whether the preoperative information recorded through a web based questionnaire together with a virtual non face to… Expand
ConditionsInternet-Based Intervention, Mobile Applications, Preoperative Period
InterventionOther
Utility of postoperative laboratory studies after female pelvic reconstructive surgery.
TLDR
Routine postoperative laboratory studies are not necessary for all patients after female pelvic reconstructive surgery and more judicious use based on clinical findings may limit unnecessary minor interventions. Expand
Preoperative Evaluation for Ambulatory and Office-Based Surgery: What We Really Need
TLDR
It is predicted that ambulatory surgeries will be close to 80 percent of all surgeries in the United States within the next couple years and lab testing and need for consults are where inconsistencies still definitely exist. Expand
Preoperative laboratory testing: Implications of "Choosing Wisely" guidelines.
TLDR
The overall evidence and key points from the Choosing Wisely guidelines are reviewed, the identification of potential wasteful practices, possible harms of testing, and key clinical findings associated with preoperative laboratory testing are reviewed. Expand
Choosing wisely in anesthesiology: the gap between evidence and practice.
To develop a "top-five" list of unnecessary medical services in anesthesiology, we undertook a multistep survey of anesthesiologists, most of whom were in academic practice, and a consequentExpand
Effect of routine pre-anesthetic laboratory screening on pre-operative anesthesia-related decision-making in healthy dogs.
TLDR
Peri-operative anesthetic management was altered in 79% of patients based on pre-anesthetic screening results; however, the overall agreement among anesthesiologists was weak with 64% of changes made by only a single anesthesiologist. Expand
Effectiveness of non-cardiac preoperative testing in non-cardiac elective surgery: a systematic review.
TLDR
There is no evidence derived from high- quality studies that supports routine preoperative testing in healthy adults undergoing non-cardiac surgery, and high-quality studies, especially large randomized controlled trials, are needed to explore the effectiveness of indicated preoper testing. Expand
Preoperative Evaluation of Patients Undergoing Non-cardiac Surgery
TLDR
Routine testing does little or nothing to aid in effective preanesthetic assessment, and postoperative complications were linked to higher ASA classification, longer duration of anesthesia, more complex surgery, and poor nutritional status. Expand
[Preoperative tests recommendations in adult patients for ambulatory surgery].
TLDR
Recent evidence suggests that patients of any age without significant comorbidity, ASA physical status gradei and grade ii, do not need additional preoperative tests routinely. Expand
The incidence of un-indicated preoperative testing in a tertiary academic ambulatory center: a retrospective cohort study
TLDR
The incidence of ordering “at least one un-indicated preoperative test” in low-risk patients undergoing low- risk surgery remains high even in academic tertiary institutions and further studies are needed to better understand the problem of overuse. Expand
The impact of reduction of testing at a Preoperative Evaluation Clinic for elective cases: Value added without adverse outcomes.
TLDR
A net reduction in preoperative testing was seen at Vanderbilt's Preoperative Evaluation Clinic from 2012 to 2015 due to anesthesia protocol changes intended to limit routine ordering of labs and imaging. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 25 REFERENCES
A Prospective Evaluation of Preoperative Screening Laboratory Tests in General Surgery Patients
TLDR
The results indicate that laboratory tests should be selectively used when the patient has appropriate risk factors, and greater emphasis should be placed on history and physical examination. Expand
A prospective evaluation of the value of preoperative laboratory testing for office anesthesia and sedation.
  • R. Haug, R. Reifeis
  • Medicine
  • Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
  • 1999
TLDR
Based on the results of this study, a good history and physical examination and then reassessment of key portions of the history were the major factors in the development of the anesthetic treatment plan. Expand
Impact of new guidelines on physicians’ ordering of preoperative tests
  • C. Mancuso
  • Medicine
  • Journal of General Internal Medicine
  • 2007
TLDR
New hospital guidelines were effective in reducing preoperative testing and did not result in increases in untoward perioperative events or in test ordering by the medical consultant. Expand
Preoperative testing is inconsistent with published guidelines and rarely changes management
TLDR
The majority of elective surgical patients undergo preoperative testing and the results of most tests were normal and influenced management in only 2.6% of cases. Expand
Do ophthalmologists, anesthesiologists, and internists agree about preoperative testing in healthy patients undergoing cataract surgery?
TLDR
It is concluded that marked variation exists within and across physician specialties in the use and rationale for use of medical tests in patients undergoing cataract surgery. Expand
Elimination of Preoperative Testing in Ambulatory Surgery
TLDR
This pilot study showed that there was no increase in the perioperative adverse events as a result of no preoperative testing in the study population, and a larger study is needed to demonstrate that indicated testing may be safely eliminated in selected patients undergoing ambulatory surgery without increasing peri operative complications. Expand
How Much Routine Preoperative Laboratory Testing Is Enough?
  • V. Velanovich
  • Medicine
  • American journal of medical quality : the official journal of the American College of Medical Quality
  • 1993
TLDR
The reasons for the potential misinterpretation of laboratory tests are discussed and then the data supporting selective preoperative laboratory testing is discussed. Expand
One-Year Experience with Day-of-Surgery Pregnancy Testing Before Elective Orthopedic Procedures
TLDR
A policy of routinely performing urine hCG pregnancy tests in women of childbearing age on the day of surgery was effective in detecting unrecognized pregnancy and resulted in a postponement of elective surgery in all cases. Expand
Guidelines for preoperative assessment: impact on clinical practice and costs.
  • A. Ferrando, C. Ivaldi, +7 authors G. Ciccone
  • Medicine
  • International journal for quality in health care : journal of the International Society for Quality in Health Care
  • 2005
TLDR
Preoperative guidelines fully introduced in practice could notably increase efficiency without affecting the quality of care and reduce costs according to different cost evaluation approaches for hospital stay. Expand
Changing Anesthesiologists' Practice Patterns: Can it Be Done?
TLDR
It was demonstrated that enhanced education and individualized feedback can change anesthesiologists' practice patterns and the actual benefit to patients from use of preventive measures was limited when used in the everyday clinical situation. Expand
...
1
2
3
...